The States With the Most Heart Disease

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25. Maryland
> Adults with cardiovascular disease: 6.9% (tied with Arizona)
> Adults who’ve had heart attack: 3.3% (14th lowest)
> Population: 6,052,177

Maryland has the highest median household income in the United States and among the lowest adult smoking rates — factors that would be more likely to result in healthier outcomes. But the adult obesity rate as well as the share of adults who do not engage in physical activity — two risk factors for heart disease — are close to their corresponding national average. This may explain why Maryland’s percentage of adults living with heart disease equals the national average of 6.9%.

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24. New Mexico
> Adults with cardiovascular disease: 7.0%
> Adults who’ve had heart attack: 3.6% (25th highest)
> Population: 2,088,070

Several negative health outcomes may contribute to New Mexico’s above average share of adults with a cardiovascular disease. Socioeconomic status may also explain why New Mexico is on the list of states with the highest incidence of heart disease. New Mexico is among the poorest states in the country — it has the second highest poverty rate and the highest share of households living in extreme poverty. People living in poverty are not only less likely to have access to health care and healthy diets, as well as tend to smoke more, but also to take longer to handle stressful situations, which can increase the risk of heart disease.

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23. Kansas
> Adults with cardiovascular disease: 7.0%
> Adults who’ve had heart attack: 3.5% (23rd lowest)
> Population: 2,913,123

No other state in the country has a higher share of adults living with high blood pressure, a known risk factor of heart disease. High blood pressure can cause damage to the arteries; it can cause the heart to work too hard, which may enlarge and thicken the heart, putting further strain on it; and eventually it can cause heart failure. Kansas is among the states with the highest prevalence of high cholesterol and obesity among adults, both of which are also known to increase the risk of cardiovascular disease.

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22. South Dakota
> Adults with cardiovascular disease: 7.2%
> Adults who’ve had heart attack: 3.9% (21st highest)
> Population: 869,666

The reasons behind South Dakota’s higher than average prevalence of heart disease are not always very clear. Yet, heart disease is the leading cause of death in South Dakota, responsible for more than a fifth of deaths in 2015. Of all major factors increasing the risk of heart disease, only one is among the highest in the country. Almost a fifth of the state’s adult population smokes, well above the national rate of 17.1%.

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21. Illinois
> Adults with cardiovascular disease: 7.3%
> Adults who’ve had heart attack: 3.5% (23rd lowest)
> Population: 12,802,023

Many of the factors that increase the risk of heart disease, such as obesity and inactivity, are similar in Illinois to the national average. Two, however, stand out — drinking and heavy weight adults. Similarly, 20.3% of adults report binge drinking, compared to 17.4% nationwide.